Clinical Retrospective Study Of Laryngeal Neoplasm Undergoing Carbon Dioxide Laser Microlaryngeal Surgery

[objective]Hoarseness in clinically often caused by laryngeal neoplasm (especially the mass of the vocal cords).Laryngeal neoplasm can be divided into benign neoplasm, precancerous lesions and malignant tumor.In recent years, the incidence of laryngeal neoplasm showed a trend of increased year by year, with the deepening of the research on the laryngeal neoplasm, the treatment of laryngeal benign lesions concept is no longer a simple surgical excision, but emphasized the etiological treatment to remove the cause and trigger.For laryngeal precancerous lesions, and cancer by as much as possible to reduce recurrence, prevent the natural processes for the purpose.The throat of the most common malignant tumor in the subglottic carcinoma, laryngeal cancer treatment is given priority to with surgical resection, the general principles of the operation on the premise of radical resection of the tumor to retain or reconstructing laryngeal pronunciation function, in order to improve the quality of life of postoperative patients.As the CO2 laser technology in recent years and the development and popularization of the microsurgery laryngoscope CO2 laser microsurgery in the treatment of laryngeal neoplasm has played a huge advantage and widely accepted.This study retrospective statistical analysis of 1443 cases between January 2005 and December 2005, because of the vocal cords of benign and malignant neoplasm in our hospital in parallel the laryngoscope under CO2 laser microsurgery in patients with clinical and follow-up data, for patients with benign neoplasm is mainly studied the characteristics of clinical history, risk factors, and the neoplasm in patients with gender, age group, and the distribution differences of professional background.Summarizes the measures of comprehensive treatment of vocal cord benign neoplasm.For CO2 laser microsurgical treatment of vocal cord leukoplakia surgery and early glottis cancer oncology curative effect, and survival analysis was studied for the patients, expect to find the influence of postoperative recurrence risk factors, for clinical decision making, selection of surgical patients and prognosis judgement to provide more clinical basis.[method]The study of basic information (age, gender, history,exposure for the alcohol and tobacco,), preoperative examination index, perioperative clinical characteristics, intraoperative and postoperative complications, preoperative and postoperative pathologic examination results, follow-up data, such as a detailed record, using SPSS 22.0 (IBM Corp, Armonk, NY) statistical software for statistical data analysis; The Kaplan-Meier survival function curve drawing method, the single factor analysis of the LOG-RANK test, and then USES the independent factors affecting the COX regression analysis. With P< 0.05 for the difference was statistically significant.[result]Benign vocal cord neoplasm patients have more obvious group characteristics, vocal nodules patients mainly consists of young and middle-aged women, and most for professional singing, middle-aged male proportion is more, in patients with vocal cord polyp is a still higher professional singing but was lower than those of vocal nodules.The laryngoscope CO2 laser microsurgery treatment of vocal cord leukoplakia overall recurrence rate was 6.90%(14/203),1.97% of total canceration rate. Its survival analysis results shown smoking, scope of vocal cord lesions, pathologic stage for recurrence. Scope of vocal cord lesions, pathologic stage for recurrence of independent factors.The laryngoscope CO2 laser microsurgery treatment early glottis cancer recurrence rate was 6.43%(11/171).Disease specific survival rates were 99.1% at 3 years and 5 years disease specific survival rate was 97.3%, the range of vocal cord lesion, mobility, the typical part bilateral or unilateral, involvement, T stage for recurrence, the scope of vocal cord lesion, bilateral or unilateral lesion, the typical part whether involving for early glottis cancer were independent factors of recurrence after surgery.[conclusion]1, Laryngeal benign neoplasm in different age and gender distribution in different population, may be related to different people different physiological and anatomical exposure factors.Centered on the laryngoscope CO2 laser surgery of comprehensive treatment in the treatment of laryngeal benign neoplasm were better.2.Smoking index, the scope of lesions and pathological grading for all affect the recurrence, and scope of vocal cord lesion, the influence factors of pathologic stage for independence.3, the laryngoscope oncology results satisfied treatment early glottis cancer. Age, the range of vocal cord lesion, activity, bilateral or unilateral involvement, the typical part whether involvement, T stage influence factors for recurrence. The scope of vocal cord lesion, bilateral or unilateral lesion, whether involving special parts for independent factors influencing the recurrence.